o Calls insurance to request claim be adjudicated
o Following up on the claims send for adjudication.
o Gathers all required appeal information for denied cases to assist in drafting the appeal
o Updates information in practice management software: Billing notes and status.
o Request client if additional medical records are needed.
o Confirms payment details if claim was paid, including payment details, date and set's follow up task
o To maintain daily productivity report.
o To draw OCR (Open Claim Report) from the system
o To prioritize the pending claims for calling from the aging basket
o To schedule the calls as prioritized to US carries and patients by considering the time zone difference
in IST and US time-zone applicable
o To make a physical call by following the international norms and applicable rules for confidentiality
and HIPAA compliance
o To report the outcome of the call in the appropriate system and to advise the team in data-team in
RCM for corrective action.
Qualification: Graduate/Under Graduate (HSC-Diploma)
Exp : Fresher
Willing to work in night shift (6pm to 3 am)
Shift Timings: US shift.
Job Location: Mumbai
Transport: Home Drop Facility + conveyance of Rs 500 pm.
Good organization skills demonstrating the ability to execute timely follow-up.
Good Oral & Written Communication skills.
Excellent spoken English skills and better accent without MTI
Awareness of US Healthcare Industry and RCM
Excellent analytical skills with understanding of health care claims processing.
MS Word and MS Excel and excellent voice culture.
o Assign proper ICD 10 codes to procedure billed.
o Make necessary changes to the claim based on Insurance and clinic updates
o Check Insurance eligibility for the visit and make necessary changes.
o Running necessary report after scrubbing claims.
Perks and Benefitsother benefits
Desired Candidate Profile
Bizmatics India Pvt Ltd
Bizmatics, founded in early 2002, provides clinical and business productivity suites and services to healthcare providers. Our first product, PrognoCIS, in the series of solutions we have planned, is an Internet based enterprise class Electronic Medical Record (EMR) solution.Accompanied by powerful scheduling module and connectivity with Labs, radiology, fax servers and practice management solutions, PrognoCIS helps clinics to transition into a paperless office. In addition to EMR, Bizmatics also has a Patient Portal solution fully integrated with EMR.
Bizmatics headquarters is located in Cupertino, CA and has customers across all over US.
Recruiter Name:Rohan Patil
Contact Company:Bizmatics India Pvt Ltd
Address :Plot no F-21, 4th Floor,, Opus Park, Opposite Seepz Gate no 1,, MIDC Central Road, MIDC, Marol Industrial Area, MUMBAI, Maharashtra - 400093,India